Etude du paiement électronique des agents de santé: cas de la campagne de vaccination contre la rougeole et la rubéole en Côte d'Ivoire / NA

La motivation des agents de santé à travers le paiement à temps et complet constitue l'un des éléments clés pour atteindre de bonne couverture vaccinale. Notre objectif était de décrire le paiement électronique utilisé lors de la campagne rubéole-rougeole et d'apprécier la satisfaction du personnel de santé. Nous avons réalisé une étude transversale à visée analytique qui s'est déroulée en Côte d'Ivoire du 15 janvier au 18 février 2019. La population d'étude était constituée des acteurs impliqués à la fois dans la campagne de vaccination contre la rougeole- rubéole en 2018 et dans le paiement électronique. Une recherche documentaire et des entretiens structurés ont permis le recueil des données. Les données ont été analysées à partir du logiciel R studio© version 2021. Le système assurant le paiement électronique se composait des autorités sanitaires, d'un opérateur privé de téléphonie mobile, d'un partenaire technique et financier et des agents de santé bénéficiaires. Un système de critères d'identification, des listes de validation et de vérification à plusieurs niveaux de la pyramide sanitaire a été mis en place. Un peu moins de trois quarts des acteurs du niveau primaire ont été satisfaits par ce mode de paiement. Le paiement électronique constitue un procédé pour améliorer le paiement des agents de santé durant les campagnes de vaccination. Des leçons d'un tel système de paiement devraient être tirées pour un déploiement à grande échelle.

Motivating healthcare workers through timely and complete payment is one of the key elements to achieve high vaccination coverage. Our objective was to describe the use of electronic payment during the measles-rubella campaign and assess the satisfaction of healthcare personnel. We conducted a cross-sectional analytical study in Côte d'Ivoire from January 15 to February 18, 2019. The study population consisted of individuals involved in both the measles-rubella vaccination campaign in 2018 and electronic payment. Data collection was done through documentary research and structured interviews. The data were analyzed using R Studio© software version 2021. The electronic payment system involved health authorities, a private mobile network operator, a technical and financial partner, and the beneficiary healthcare workers. A system of criteria for identifying lists, validation, and multilevel verification within the healthcare pyramid was established. Just under three-quarters of primarylevel actors were satisfied with this payment method. Electronic payment presents an opportunity to improve healthcare worker payment during vaccination campaigns. Lessons from such a payment system should be drawn for large-scale deployment.

Effect of Brine Concentration on Bacteria Isolated from Leafy Vegetables (Talinum triangulare, Telfairia occidentalis and Vernonia amygdalina)

The effect of brine on bacteria isolated from leafy vegetables was evaluated. Fresh waterleaf (Talinum triangulare), Pumpkin leaves (Telfairia occidentalis) and Bitter leaves (Vernonia amygdalina) including cooking salt were bought from vendors in Mile 3 market, Port Harcourt, Rivers State. Brine concentrations of 1, 2, 3, 4 and 5% were prepared by dissolving appropriate grams of salt in distilled water. Nine millilitres of the respective concentrations were transferred into clean test tubes, labelled, stoppered with foil and autoclaved at 121? for 15 minutes at 15psi. Sterile distilled water served as a control. The test isolates were standardized based on 0.5McFarland and 1mL each was introduced into different brine concentrations. The standard plate count was used to monitor brine effects on isolates and this was done hourly for six hours. Inoculated plates were incubated at 37? for 24 hours. After incubation, enumerated colonies were used to deduce isolate mortality. The total heterotrophic bacterial (THB) load of bitter, Pumpkin and water leaves were 3.49±0.4×106, 3.25±0.4×106 and 1.99±0.2×106 CFU/g, respectively. The staphylococcal counts for bitter, Pumpkin and water leaves were 1.65±0.3×104, 3.13±0.5×104 and 1.55±0.4×104 CFU/g, respectively. Total coliform counts for bitter, Pumpkin and water leaves were 1.52±0.8×105, 2.85±0.1×105 and 1.75±0.6×105 CFU/g, respectively. Staphylococcal counts of pumpkin leaves were significantly (P?0.05) higher than those obtained for bitter leaf and water leaf. There was no significant difference(P>0.05) in the THB and Coliform counts of all samples. E. coli was predominant in Pumpkin and water leaves while Staphylococcus sp was predominant in bitter leaves. The LC50 values for E. coli, Klebsiella, Staphylococcus, and Bacillus sp were; 5.39, 3.88, 1.62, and -0.41mg/ml, respectively. The LC50 showed that the brine was very lethal on Bacillus sp and Staphylococcus sp. High brine concentration is recommended to achieve reduced bacterial load.

Analyse du coût économique direct du cancer du sein en Côte d'ivoire en 2022 / NA

La prise en charge du cancer du sein constitue un fardeau économique important dans les pays àressources limitées. L'objectif était d'estimer les coûts médicaux directs des patientes suivies pour un cancer du sein en côte d'ivoire Une étude transversale a été conçue et réalisée dans les principales structures sanitaires de référence en gynécologie-obstétrique et en oncologie en Côte d'Ivoire. L'étude incluait les patientes avec un cancer du sein confirmé par l'histologie. Les données ont été recueillies à partir des dossiers médicaux et des entretiens avec les patientes. Au total, 102 patientes à différents stades de la maladie ont été incluses dans l'étude. Les coûts augmentent aux stades avancés. La chimiothérapie était le principal facteur de coût (3 121 $ par patiente) avant la radiothérapie (1 714 $). Les femmes atteintes d'un cancer du sein ont dû faire face à un coût moyen estimé à 442 $ (allant de 322 $ à 933 $). Le coût de la radiothérapie était également exorbitant (1 714 $ par patient). La chirurgie était le traitement le moins onéreux (1 416 dollars). Le coût total moyen des examens radiologiques et des tests de laboratoire s'élevait respectivement à 304 et 247 dollars. Les soins de suivi ont été estimés à 631 dollars. Cette étude fournit une analyse perspicace qui servira de base à une évaluation économique plus poussée et pourrait également être utile aux décideurs en matière de santé pour l'inclure dans le plan national de couverture de la santé.

The management of breast cancer is a major economic burden in countries with limited resources. The aim was to estimate the direct medical costs of patients treated for breast cancer in the Ivory Coast. A cross-sectional study was designed and carried out in the main referral health facilities for gynaecology-obstetrics and oncology in the Ivory Coast. The study included patients with histologically confirmed breast cancer. Data were collected from medical records and patient interviews. A total of 102 patients at different stages of the disease were included in the study. Costs increase in advanced stages. Chemotherapy was the main cost factor ($3,121 per patient), followed by radiotherapy ($1,714). Women with breast cancer faced an estimated average cost of $442 (ranging from $322 to $933). The cost of radiotherapy was also exorbitant ($1,714 per patient). Surgery was the least expensive treatment ($1,416). The average total cost of radiological examinations and laboratory tests was $304 and $247 respectively. Follow-up care was estimated at $631. This study provides an insightful analysis that will serve as a basis for further economic evaluation and could also be useful to healthcare decision-makers for inclusion in the national health coverage plan.

Facteurs de demande de services de santé préventifs en contexte épidémique (Dengue et COVID 19), Côte d'Ivoire, 2020 / NA

Introduction : L'une des missions de l'Institut National d'Hygiène est de prévenir et contrôler les maladies transmissibles et autres urgences de santé publique à travers ses services compétents. En situation de crises sanitaires comme une épidémie, les besoins augmentent et alors les bénéficiaires sont exemptés de paiement pour toute intervention préventive de masse. Le paiement rentre en vigueur lorsque la demande est exprimée dans une perspective individuelle. L'objectif de l'étude était d'analyser les facteurs de la demande des prestations du service de lutte anti-vectorielle (LAV) en période épidémique de Dengue et de COVID-19. Méthodes : Une étude transversale a été réalisée de janvier 2018 à décembre 2020 dans une antenne communale, celle d'Abobo. La collecte des données a été effectuée à travers une revue documentaire et l'administration d'un questionnaire auprès du gestionnaire et des techniciens du centre. L'analyse des données a été réalisée avec le tableur Excel. Résultats : La recette cumulée du service LAV pour ces trois dernières années s'élèvait à 57 708 100 F CFA (≈ 88 103 €) avec une accentuation de l'ordre de 65,6% en 2020, année de pandémie à Covid-19. Les ménages ont été pour les trois années, les principaux demandeurs du service LAV. Leurs recettes cumulées s'élevaient à 22 663 120 FCFA (≈ 34 600 €). Les facteurs de la demande pour le service LAV étaient le lieu de résidence, le niveau d'instruction, le niveau de revenu et la source d'information. Conclusion: La pandémie à COVID 19 a favorisé une augmentation plus importante des recettes. Les gestionnaires du centre devront ajuster les objectifs de recettes en tenant compte des facteurs de la demande en service de soins préventifs.

Introduction: The National Institute of Hygiene's mission is to prevent communicable diseases andother public health emergencies. During health crises, beneficiaries are exempt from payment. The study's objective was to analyze the factors that influence the demand for vector control services during Dengue and COVID-19 epidemics. Methods: This was a cross-sectional study from January 2018 to december 2020 at the Abobo public health unit. Data collection was done through a literature review and the administration of a questionnaire. Data analysis was performed using Excel software. Results: The cumulative revenue of the LAV service for the last three years amounted to 57,708,100 F CFA (≈ 88,103 €). Households were the principal applicants for the LAV service for the three years. Their cumulative revenue amounted to 22,663,120 FCFA (≈ 34 600 €). Factors influencing demand for the LAV service were residence, level of education, income level, and source of information. Conclusion: Center managers will need to adjust revenue targets by considering demand factors for preventive care services.

Sexual Risk Practices of Undergraduate University Students in the Niger Delta Region of Nigeria: Implications for Planning Interventions.

Aim: To evaluate the sexual practices of undergraduate university students in the Niger Delta region of Nigeria in order to provide evidence for appropriate interventions. Study Design: A multi-stage random sampling design and stratified sampling proportionate to size was used to select study participants. Place and Duration of Study: The study was carried out in four out of the 18 public universities in the region between October and December 2013. Methodology: An anonymous questionnaire was administered to 828 students selected from four faculties and eight departments of the universities. Married students and those from departments of medical and health sciences were excluded. Data was analyzed using Epi Info ver. 6.04d software package. The Chi-square test was performed at 95% confidence level and p-value set at P=.05. Results: A total of 391(47.2%) males and 437 (52.8%) females participated in the study. The majority of the students 444(53.6%) were in sexual relationships: 150 (33.8%) males and 294 (66.2%) females. Of these, 358 (80.6%) had had an HIV test and knew their HIV status: males 125 (34.9%) and females 233 (65.1%), but only 280(63.1%) had knowledge of the HIV status of their sexual partners: males 93(33.2%) and females 187 (66.8%). More females than males knew their HIV status and those of their sex partners (p=.00). Similarly, only 216(48.6%) used condoms in their last casual sex, while only 145(32.7%) used condoms consistently with a non-regular partner: males 71(49.0%) and females 74(51.0%) respectively. Finally, less than half of the students 216(48.6%) were consistent with safer sex negotiation with their partners. Conclusion: The study highlights the occurrence of high sexual risk behaviours among undergraduate university students. We advocate the inclusion of sexuality education in the General Studies curriculum for students and the provision of accessible Sexually Transmitted Infection services through youth-friendly channels, like Youth Friendly Centres.

The Pattern of Female Genital Mutilation in Port Harcourt, Southern Nigeria.

Aims: Female genital mutilation is a harmful traditional practice which is an infringement on the sexual and reproductive rights of women and girls and has profound psychosocial as well as reproductive health morbidities. This study aimed at measuring the change in the incidence of the female genital mutilation in Port Harcourt, South-South Nigeria. Study Design: A cross-sectional study. Place and Duration of Study: Department of ObstetricGynaecology of the University Port Harcourt Teaching Hospital (UPTH) between 1st January and 31st January 2009. Methodology: Five hundred clients were selected randomly and agreed to participate in the study. They were interviewed using a structured questionnaire and examined clinically. Data management was with SPSS 15.0 for Windows statistical software. Results: The prevalence of female genital mutilation (FGM) was 34%. Four hundred and eighty one (96.2%) were aware of female circumcision generally. Ninety five (55.8%) of those circumcised, had it done in infancy. Thirty seven percent of the practitioners of female circumcision were traditional birth attendants while 14.7% were trained health professionals. The commonest reason for female circumcision included reduction of sexual passion/promiscuity and conformity with tradition. Type 1 female genital mutilation was the commonest (58.2%). Among those clients aged 50 years and above, 78.8% had FGM while 9.1% of those aged 10 – 19 years had FGM. This showed a downward trend. Conclusion: Female circumcision is a harmful traditional practice which has remained a serious health problem. Its prevalence is still high in our environment. This study suggests that it is on a downward trend.

Socio-Demographic Profile of People Living with HIV/AIDS (PLWAs) in Port Harcourt; Nigeria

BACKGROUND AIDS is one of the important health problems facing developing countries particularly in sub-Saharan Africa. It constitutes a major public health threat responsible for morbidity and mortality in these areas. It is a debilitating disease of profound immunosuppression produced by chronic infection with human immunodeficiency virus (HIV) and if not treated exposes the person to a myriad of opportunistic infections. HIV/AIDS is generally regarded as a social disease because of its mode of transmission and the associated lifestyle involved. The study was designed to evaluate the socio-economic profile of People Living with HIV/AIDS (PLWAs) in Port Harcourt; Rivers State; Nigeria. METHODS.Structured questionnaires were used to collect socio-economic characteristics of demographic information from recruited participants who were attendees of HIV adult clinics at two hospitals in Port Harcourt; Nigeria. RESULT.A total of 145 people completed the study. There were 46 (31.7%) males and 99 (68.3%) females. Data collected showed that age; sex; marital status; education are important factors associated with the characteristics of people living with HIV!AIDS in Port Harcourt; Nigeria. CONCLUSION.There is need for continuous evaluation/monitoring of these characteristics in PLWHA to assess the improvement of socio-economic factors that influence HIV spread in the environment

Correlation between annual activity patterns of venomous snakes and rural people in the Niger Delta, southern Nigeria

Background: Venomous snakes are among the most serious health hazards for rural people in tropical regions of the world. Herein we compare the monthly activity patterns of eight venomous snake species (Elapidae and Viperidae) with those of rural people in the Niger Delta area of southern Nigeria, in order to identify the periods of highest potential risk for persons, and the human group actually at greater risk of snakebite. Results: We documented that above-ground activity of all venomous snakes peaked in the wet season, and that high snake activity and high human activity were most highly correlated between April and August. In addition, we documented that women and teenagers were at relatively higher risk of encountering a venomous snake than adult males, despite they are less often in the field than men. Conclusions: Our results suggest that future programs devoted to mitigate the social and health effects of snakebites in the Niger Delta region should involve especially women and teenagers, with ad-hoc education projects if appropriate. We urge that international organizations working on social and health problems in the developing world, such as IRD, DFID, UNDP, should provide advice through specific programs targeted at especially these categories which have been highlighted in comparatively potential higher threat from snakebites than adult men.(AU)

Respiratory symptoms amongst females in a fishing settlement in the Niger Delta, Nigeria

Background: Approximately half of the earth's population in the rural areas of developing countries uses energy obtained from biomass burning, which is harmful to people. Objectives: This study is aimed at determining which respiratory symptoms can be associated with biomass burning amongst fish smokers in the Oyorokoto fishing settlement. Method: A community-based, cross-sectional questionnaire, which employed a modified cluster sampling technique, was used. Results: A total of 300 subjects were recruited for the study, of which 210 (70%) were fish smokers. The mean age was 31.46 ± 13.03 years, with the majority (42.0%) having only primary school education. The prevalence of respiratory symptoms amongst the subjects was 86.7%, the most frequent of which were catarrh (30.48%) and a cough (28.57%). The respiratory symptom occurring least frequently was breathlessness (2.38%). The symptoms most often experienced during fish smoking were those of catarrh (75.5%) and sneezing (73.0%), whereas breathlessness occurred the least, in only 7 (3.3%) of the participants. Sneezing stopped in 64.2% of the subjects after fish smoking had ceased. Most of the fish smoking took place indoors. Conclusion: Health promotion featuring preventive interventions, such as the wearing of face-masks and the use of modern fish smoking methods, which is associated with fewer health risks, is essential to improving the quality of life of fish smokers. The government's provision of certain social services, including better education opportunities for the young, is advocated, and should be especially targeted at improving the lot of the girl child

Mothers Perception of Sexuality Education for Children

Background:Sexuality education is the process of acquiring information and forming attitudes and beliefs about sex; sexual identity; relationships and intimacy. It develops young people's skills so that they make informed choices about their behaviour; and feel confident and competent about acting on these choices. It also equips children to face developmental challenges and empowers them against the ills of abuse; exploitation; unwanted pregnancies amongst others. Mothers who are the primary caregivers should be well informed about sexuality issues. The objective of the study is to determine mothers' perception of sexuality education in children; in PortHarcourt. Methodology:A structured; anonymous and selfadministered questionnaire; used as instrument for data collection; was distributed amongst a convenient sample of women attending a Christian women's convention in Port Harcourt. Results:One hundred and fifty eight women participated in the study. Most of them were married (80.4); and belonged to the 30-49 years age bracket. Seventy one (44.9) of the respondents had tertiary education. Over 80agreed that children needed sexuality education but only 15 women (9.5) had a good knowledge of the concept of sexuality education. One hundred and eleven (70.2) believed it was the responsibility of both parents to educate their children and over 70acknowledged that the home was the best place for such education. 64 (40.5) believed that 6-10 years was the ideal age for starting sex education while 49thought that the ideal age was 11-15 years. 65of respondents discussed sexuality issues with their children at least occasionally; the content mostly involved description of body parts and reproductive organs. The average age of menarche amongst respondents was 14.0. One hundred (63) of the women had prior knowledge of menstruation before menarche. About half of them had received information from their mothers. Conclusion:The study highlights the need for enlightenment of women on sexuality education to enable them empower their children against the ills of child abuse

Mothers Perception of Sexuality Education for Children

Sexuality education is the process of acquiring information and forming attitudes and beliefs about sex; sexual identity; relationships and intimacy. It develops young people's skills so that they make informed choices about their behaviour; and feel confident and competent about acting on these choices. It also equips children to face developmental challenges and empowers them against the ills of abuse; exploitation; unwanted pregnancies amongst others. Mothers who are the primary caregivers should be well informed about sexuality issues. The objective of the study is to determine mothers' perception of sexuality education in children; in Port Harcourt.A structured; anonymous and selfadministered questionnaire; used as instrument for data collection; was distributed amongst a convenient sample of women attending a Christian women's convention in Port Harcourt.One hundred and fifty eight women participated in the study. Most of them were married (80.4); and belonged to the 30-49 years age bracket. Seventy one (44.9) of the respondents had tertiary education. Over 80agreed that children needed sexuality education but only 15 women (9.5) had a good knowledge of the concept of sexuality education. One hundred and eleven (70.2) believed it was the responsibility of both parents to educate their children and over 70acknowledged that the home was the best place for such education. 64 (40.5) believed that 6-10 years was the ideal age for starting sex education while 49thought that the ideal age was 11-15 years. 65of respondents discussed sexuality issues with their children at least occasionally; the content mostly involved description of body parts and reproductive organs. The average age of menarche amongst respondents was 14.0. One hundred (63) of the women had prior knowledge of menstruation before menarche. About half of them had received information from their mothers. The study highlights the need for enlightenment of women on sexuality education to enable them empower their children against the ills of child abuse

Tumours of the Vulva in Port Harcourt; Nigeria. A 13-Year Clinico Pathological Study

The aim is to ascertain the pattern and frequency of vulval tumours as seen at the University of Port Harcourt Teaching Hospital. Forty (40) vulval tumours were used for the study. Twenty nine (72.5) were benign and eleven (27.5) were malignant. Patients of age 50 years and above were most affected 24(60). The most common clinical presentation was elevated and ulcerated plaques9 (22.5). Condyloma accummatum was the most common benign tumour while squamous cell carcinoma was the most common malignant tumour. It is concluded that vulval tumours are rare in this environment and that the malignant variants present at advanced stage of the disease in later ages. They constitute a remarkable morbidity and mortality especially in the obese and chronically ill menopausal women

Mothers' Knowledge and Perception of Child Sexual Abuse

Background: Sexual abuse in children is a significant public health problem and represents the least reported but the most devastating major form of child abuse all over the world. Aim: To evaluate the knowledge and perception of child sexual abuse among Christian women in Port Harcourt. Methods: This study was conducted among women attending a Christian women convention. Using a structured; anonymous and self-administered questionnaire; data collected included bio data; awareness information; response and practices. Data was entered into a Microsoft Excel Spread sheet and analysed using descriptive statistics. Results: One hundred and fifty-eight women participated in the study of whom 127 (80.4) were married and 51 (32.3) belonged to the 30-39 years age bracket. Twenty-two (13.9) respondents had never heard about sexual abuse in children; whilst 70 of them (44.2) knew that under-five children can also be victims. Forty four percent of the respondents believed the abuser is not someone closely related to the child. In case of rape; seeking medical care will be the first line of action for 119 (75) respondents and only 55 (34.7) will report the case to the police. Unwanted pregnancy was the single most quoted consequence of child sexual abuse; shame and stigmatization the greatest challenges faced by the family. Conclusion: The study shows that mothers who should play a major role in the prevention of sexual abuse in children have poor knowledge about the topic. There is therefore need for awareness/enlightenment campaigns about child sexual abuse targeted at parents; especially mothers

Evaluation of Health Knowledge of Teachers in Public Primary Schools in Bonny Local Government Area of Rivers State

Background: The noncompulsory nature of health education as a subject in some teacher training colleges and the generalists' position of teachers in primary schools raise concern over the teachers' health knowledge and the accuracy of health information that pupils are given. Aim: The study was undertaken to evaluate the health knowledge of primary school teachers and to assess the effect of short term training on their health knowledge. Methods: This was a school-based intervention study carried out in June 2006. Health knowledge of all teachers from the 20 public primary schools in Bonny Local Government Area of Rivers State was assessed before and after a workshop on school health using a health knowledge assessment test. Scores of 50and more were regarded as pass. Data was analyzed using SPSS version 11 software. Test for statistical significance was done using Chi-square test and student t-test. P value less than 0.05 was regarded as statistically significant. Results: Twenty nine of the 100 participants (29) passed the pre-test. These were holders of University degrees [13 (56.5)]; National Certificate of Education [13 (28.3)] and Teachers' Grade II Certificate (TCII) [3(10)]. Post workshop; health knowledge improved across board as all the teachers passed (p=0.000). Conclusion: The health knowledge of school teachers from public primary schools in Bonny local government area is low. This was worse among those with lower academic qualifications (TCII and below). However this improved following a short term training workshop

Familial Acute Lymphoblastic Leukaemia

Background: Acute lymphoblastic leukaemia (ALL) is known to be the most common malignancy in children. However; the true incidence of familial ALL is not known; coupled with scanty data on familial ALL in the Niger Delta Area of Nigeria. Aim: To present a report of the management two cases of ALL from the same parents; whose sibling also died as a diagnosed case of ALL. Case report: The first case was a 30-month female who presented with recurrent febrile illness; repeated blood transfusions and hospitalizations in several private hospitals before being referred to the Department of Paediatrics and Child Health; University of Port Harcourt Teaching Hospital; Port Harcourt. A diagnosis of ALL type 1 was made. She was managed with cyclophosphamide; oncovin; methotrexate and prednisolone (COMP). Induction regimen; antimalarials and transfusion of sedimented red blood cells for severe anaemia were administered. There was remission before the child was lost to follow-up. The second case was a 15-month female sibling of the first case who presented essentially with severe anaemia; generalized weakness; repeated blood transfusions; peripheral lymphadenopathy and a non-tender hepatomegaly. Bone marrow aspiration showed features also suggestive of ALL type 2 variant with over 30abnormal lymphoblastic and leukaemic cell infiltrate. She was subsequently put into remission through an induction regimen of COMP plus intrathecal methotrexate and Hydrocortisone. She however relapsed and died 8 months from the time of presentation. Conclusion: Familial ALL in siblings is reported. The interplay of the associated risk factors of genetic; parental; socio-economic and environmental influences on the incidence of familial leukaemia in this environment is discussed

Complications de l' epaule de l'hemiplegique vasculaire : prevalence et facteurs associes au sein d 'une population de cerebroleses vasculaires au Chu d'Abidjan (Cote D'ivoire)

Objectif Evaluer la fréquence des complications de l'épaule de l'hémiplégique vasculaire et identifier les facteurs associés à ces complications Méthodes C'est une étude prospective réalisée entre Juin et Octobre 2005 au Centre hospitalo-universitaire de Cocody (Abidjan, Cote d'Ivoire). Elle concerne des patients admis en consultation de rééducation fonctionnelle (RF) ou en hospitalisation de neurologie.Résultats Cinquante patients âgés en moyenne de 56,6 ± 13,4 ans (extrêmes de 29 et 85 ans) avec un sexe ratio de 1,17 en faveur des femmes, recrutés le plus souvent en RF (60%) ont été inclus dans cette étude. Ils avaient un accident vasculaire cérébral (AVC) principalement ischémique (72%), qui évoluait en moyenne depuis 11,3 ± 12,9 semaines. Parmi eux 28 (56%) avaient une complication de l'épaule qui était : une douleur (DL, n=25), un syndrome épaule-main (SEM, n=10) ou une subluxation (SUB, n=18). Ces complications étaient associées dans 46,4% des cas. Ces patients étaient plus âgés, avaient un AVC plus ancien, un index moteur du membre supérieur plus faible mais un niveau d'autonomie globale semblable à celui des patients sans complications. Ni l'âge, ni la durée d'évolution de l'AVC n'était différent selon le type de complication diagnostiqué. La fonctionnalité était associé à la SUB (dans 72,2% des SUB le Frenchay arm test était égal à 0 vs 37,5% chez les patients sans SUB p=0,02) tandis que le tonus des adducteurs du bras était associé à la DL (dans 40% des DL le tonus des adducteurs était égal à 1 vs 84% chez les patients ne présentant pas de DL p=0,006).Conclusion L'épaule douloureuse de l'hémiplégique est donc une complication fréquemment retrouvée dans notre étude. Des études ultérieures seront utiles pour conforter la fréquence de ces complications, l'impact des différents facteurs qui semblent s'y associer et analyser les possibilités de prise en charge tant curative que préventive dans notre milieu

Sero-Prevalence of Hepatitis C Antibodies in Pregnant Women in Port Harcourt; Nigeria

Background: Hepatitis C virus (HCV) infection is now a pandemic; with most of those infected thought to be in developing countries; including sub-Saharan Africa. HCV has emerged as the most important cause of chronic liver disease worldwide and an important cause of acute hepatitis and jaundice in pregnancy; with its attendant serious complications. Aim: To provide some preliminary data on HCV epidemiology in pregnant women in Port Harcourt; Nigeria. Methods: Serial recruitment of 600 patients attending the ante-natal clinic of the University of Port Harcourt Teaching Hospital; Port Harcourt; Nigeria was carried out. HCV testing was done using a rapid ELISA kit. The results are reported as percentages of the total study population. Differences between the groups were compared using the chi-squared test and p0.05 was regarded as statistically significant. Results: Of the 600 subjects; 26 (4.3) tested positive to anti-HCV. Previous histories of blood transfusion; dental manipulations; tattooing and circumcision did not appear to be important modes of transmission of HCV in this locality. Conclusion: HCV infection is fairly common among pregnant women in Port Harcourt; Nigeria. It is sug- gested that in addition to improved compliance with universal safety precautions; ante-natal patients and healthcare staff should be routinely screened for their HCV status in order to reduce vertical transmission of HCV and transmission between patients and health staff

Human Bite and Human Immune Defiency Cirus (HIV) Transmission

Background: The concentration of human immune deficiency virus (HIV) in the saliva of a carrier is low. As a result; human bite is not considered the traditional route of HIV infection transmission.Aim: To report a case of HIV sero-positivity following a human bite. Setting: University of Port Harcourt Teaching Hospital; Port Harcourt.Case report: A 30-year-old HIV sero-negative woman who became sero-positive following a bite by a known HIV infected commercial sex worker is presented. Both were engaged in a physical fight over a disagreement.Conclusion: This case highlights the possibility of HIV infection through human bite